Wednesday, April 14, 2010

I'm not sure what to do. Well, no: I am sure what to do, and I've told Boss Lady what will have to happen for me to accept the new job. I'm just not sure she can make it happen.

Sunnydale's CCU has become less neuroscience-focused and more everything-surgical over the last five years. For me, this is bad: I like neuroscience, and I like working with patients who have weird stuff wrong with their brains. A good day, for me, is brain worms and undiagnosed CNS disorders and a couple of glioma resections. A fair day is a fresh head-and-neck dissection. A bad day is freaking kidney resections and freaking gut resections; I've had a lot of bad days lately.

Because Sunnydale's historic focus has been on research and neuroscience, the change to Big Al's Surgi-Mart has been bad for the hospital, as well. There simply aren't enough CCU beds to accomodate folks with brain problems.

So Sunnydale is opening a new critical care unit, focused strictly on neuroscience. I have been offered the chance to be one of the very first nurses on that unit. Clinical trials would take place there; we'd see brand-new strokes; people with weird shit would be in there all the time.

It sounds great. It's a daytime position, and it's just what I want to do.

The problem? The start-up budget is zero. There are cannibalized beds and pumps all over the new unit, and some of the rooms have only portable monitors in them. We don't even have a dedicated EEG monitor. There is also no dedicated moolah for nurses; my wages would come from a combination of general funds and the current CCU budget.

I've told Boss Lady that three things have to happen in order for me to take the job:

First, I have to be guaranteed hours. As I told her, I do not have two incomes in my household; I am sole support of myself and three hungry animals. No hours, no bueno.

Second, if the opportunity arises for me to go back to a guaranteed daytime shift in the CCU, I want first dibs. Not third, not second, not "Let's wait and see what happens". First dibs. It's job security I can't afford to be without at this point, especially as Sunnydale's last try at a secondary CCU petered out after a few months due to lack of funds.

And third, if the job goes away (see petering out, above), I get moved to CCU on days, period. At full-time hours. No excuses, no exceptions.

Boss Lady came in seventy-two hours before my one-month deadline for finding a solution. For that I give her full marks. I'm just hoping that she, and Sunnydale's army of neurologists and neurosurgeons, can make this new CCU work and grow.

The chance to shape the care of neuroscience patients in a critical and acute-care setting is absolutely phenomenal. I have *lots* of ideas about how things should be done, starting with things like how soon we start physical and occupational therapy and continuing on to how the damn place should be set up (hint: it's nice to be able to see all your patients in the CCU, not have some of them stuck back in what's essentially a closet). I would love to be part of a research team again and to work on clinical trials. We've got a double-blind coming up that sounds fantastic.

Any prayers, positive thoughts, and general good kharma anybody feels inclined to send out will be gratefully accepted. This could be the start of something absolutely magnificent; it just has to get rolling. And get money. And get patients.

Positive thoughts your way! I was in a similar position re: pediatric critical care - don't forget education as a part of your list..especially if you don't have an experienced team of nurses behind you or proper equipment:)Even borrowing some pathways, etc. from other neuro-focused facilities in your area..